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EMT-Intermediate Curriculum Rollout Medication Administration Terms and Key Points Medication Administration Asepsis Disinfectants versus antiseptics Drawing medications from ampules, vials, nonconstituted vials; administration through preload syringes, subcutaneous and IM routes Familiarity with the following procedures and equipment: Enteral drug administration Intramuscular drug administration Obtaining a blood sample Burette chamber or Soluset Blood-Y intravenous administration set Medical Mathematics Metric Prefixes and conversion between prefixes - Kilo - Deci - Mili - Micro Weight conversion from pounds to kilograms Calculating doses for parenteral medications Calculating weight-dependent doses Calculating infusion rates (medicated infusions) 1. True/False of Medication Administration _____ The total dose of a drug packaged at 4mg/ml in 25 ml of solution would be 100mg. _____ The concentration of a drug is always displayed in mg. _____ Ampules usually hold no more than 5ml of a solution. _____ Before breaking the ampule, the top of the ampule should be tapped until all of the medication is located at the bottom portion. _____ Before withdrawing medication from a vial, you should inject the vial with the same volume of air that you will be withdrawing in solution. _____ Injecting a vial with air before retrieving medication is important because is prevents an implosion of the bottle. _____ A nonconstituted vial is essentially a medication that is suspended in a solution that keeps the medication from being dissolved. _____ Subcutaneous injections should be administered at a 60-degree angle. _____ No more than 3mL should be administered via the subcutaneous route. _____ An ”air plug” of 0.1mL is given primarily to force the medication deeper into the tissue in a subcutaneous injection. _____ No more than 2mL should be administered in an intermuscular injection. _____ Drugs given IV should be administered through an 18-20 gauge needle. _____ For a medication infusion, either a macrodrip or microdrip administration can be used for the secondary (medication) line. _____ Once the medication is injected into an IV bag in a medication infusion, the bag should be shaken vigorously in order to dissolve the drug. _____ The secondary (medication) line of a medication infusion should be “plugged in” to the primary line. The primary line should be set at TKO and the secondary line should be set to the desired drip rate for the medication. 7. Drug Calculations References for drug math and performing calculations are included in the EMTIntermediate Bridge Course CD. Convert the following: 3569mg = ________ mcg 0.3mL = _________ L 800mcg = _________ mg 0.8L = _________ mL Weight conversions – instead of using a calculator, try to calculate kg via the “field way” by dividing the pounds by 2 and then subtracting the new number by 10%. Example: 687 pounds/2 = 343.5 –10% = 309kg-ish 145 pounds = _______ kg 60 pounds = ______ kg 395 pounds = ______ kg 182 pounds = ______ kg Drug Math: You have a vial of furosemide that holds 120mg in 6mL of solution. What is the concentration of the drug in mL? (mg/mL) What is the dose for the drug as listed in the Jackson County Standing Orders (pick one)? How many mL will you draw up for the desired dose above? You have a vial of epinephrine that holds a total of 30mL of a 1:1000 solution. The total mg in the vial is 30mg. You must give 0.01mg/kg of the drug to a 120kg patient. What is the concentration of the drug in the vial per mL of solution? What is the dose that you need to give to the patient in mg (desired dose)? How many mL will you draw up into the syringe? Patient weighs 285 pounds. You want to administer 2mg/kg of the drug. What is your dose in mg? You are transporting an elderly female to another hospital. She has an IV in place with an order for the solution to run at 200mL/hour. You have a 15gtt/mL set. What is the gtt/min? You are preparing to administer a lidocaine infusion at 2mg/min. You have 2 grams of lidocaine in 500mLs of normal saline. What is your drip rate (gtt/min)? You are running the infusion from #7 above. You notice the maintenance infusion is not preventing the patient’s PVCs from returning. You want to increase the rate to 3mg/min. What is your new drip rate (gtt/min)? You are to administer 85mg of a drug. The drug is packaged as 100mg in 5 mLs of solution. How many mLs would you administer? You are to administer 120 mg of another drug. It comes packaged as 100mg in 5mLs. How many mLs would you administer?